Yоu аre аdministering hepаrin and fоllоwing the protocol below for a client weighing 189 lbs. The order is to administer an initial heparin bolus IV followed by a titrated IV infusion. Round to the tenths place. HEPARIN PROTOCOL Initial bolus- 50 units/kg Initial rate – 18 units/kg/h Obtain a PTT every 6 hours, and adjust dosage and rate as follows: If PTT is less than 35 secs: Repeat bolus with 80 units/kg and increase the rate by 4 units/kg/h If PTT is 36 to 44 seconds: Repeat bolus with 40 units/kg and increase the rate by 2 units/kg/h If PTT is 45 to 75 seconds: Continue current rate. If PTT is 76 to 90 seconds: If PTT is 76 to 90 seconds: Decrease rate by 2 units/kg/h If PTT is greater than 90 secs: Hold the heparin for 1 hour and decrease rate by 3 units/kg/h Available (for bolus) - heparin 1,000 units/mLAvailable (for infusion) - heparin 25,000 units in 250 mL D5W What rate will the nurse set the pump at for the titrated heparin IV infusion in response to the PTT of 40 secs?
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